Loss of Health Promoting Bacteria in the Gastrointestinal Microbiome of PICU Infants with Bronchiolitis: A Single-Center Feasibility Study.

Madeleine M Russell,Surender Rajasekaran,Mara L Leimanis-Laurens,Shao Thing Teoh,Karen Ferguson,Sarah S Comstock,Sihan Bu,Sophia Y Lunt,Ruth-Anne L Mckee,Jeremy W Prokop,Gigi A Kinney,John W Winters

doi:10.3390/children9010114

Abstract

The feasibility of gastrointestinal (GI) microbiome work in a pediatric intensive care unit (PICU) to determine the GI microbiota composition of infants as compared to control infants from the same hospital was investigated. In a single-site observational study at an urban quaternary care children’s hospital in Western Michigan, subjects less than 6 months of age, admitted to the PICU with severe respiratory syncytial virus (RSV) bronchiolitis, were compared to similarly aged control subjects undergoing procedural sedation in the outpatient department. GI microbiome samples were collected at admission (n = 20) and 72 h (n = 19) or at time of sedation (n = 10). GI bacteria were analyzed by sequencing the V4 region of the 16S rRNA gene. Alpha and beta diversity were calculated. Mechanical ventilation was required for the majority (n = 14) of study patients, and antibiotics were given at baseline (n = 8) and 72 h (n = 9). Control subjects’ bacterial communities contained more Porphyromonas, and Prevotella (p = 0.004) than those of PICU infants. The ratio of Prevotella to Bacteroides was greater in the control than the RSV infants (mean ± SD—1.27 ± 0.85 vs. 0.61 ± 0.75: p = 0.03). Bacterial communities of PICU infants were less diverse than those of controls with a loss of potentially protective populations.

Highlights

The first 2 years of life are critical in the establishment of the human gastrointestinal (GI) microbiome, the composition of which has been increasingly associated with long-term health outcomes [1,2]
For all pediatric intensive care unit (PICU) infants enrolled in the study, the most common mode of feeding at baseline was a nasogastric tube (n = 5), followed by per os (PO) or none at (n = 3) each, and one infant was fed by orogastric (OG) tube
We describe the GI microbiome in PICU patients (

Summary

Introduction

The first 2 years of life are critical in the establishment of the human gastrointestinal (GI) microbiome, the composition of which has been increasingly associated with long-term health outcomes [1,2]. The gut microbiota exists in a mutualistic relationship with the host and its surroundings, and its diversity increases rapidly in the first months of life through exposure to microbes from the diet, home, and environment [3]. Ill adult patients develop intestinal dysbiosis and experience a loss of health-promoting bacteria in their intestinal microbiome during intensive care unit (ICU) admissions [5,6]. This phenomenon is poorly understood for infants in the pediatric ICU (PICU)

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